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Transforming Mental Health Services

Implementing the Federal Agenda for Change

Edited by Howard H. Goldman, M.D., Ph.D., Jeffrey A. Buck, Ph.D., and Kenneth S. Thompson, M.D.

  • 2009
  • 123 Pages
  • ISBN 978-0-89042-455-1
  • Item #2455

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This compendium of 17 articles addresses the goals set forth by the President's New Freedom Commission on Mental Health in its 2003 report, Achieving the Promise: Transforming Mental Health Care in America. The report represents the first time since the Carter Administration that such a high-level group evaluated U.S. mental health care. The report painted a dismal picture of the nation's mental health system, saying the system was so broken that it was beyond simple repair. The Commission said that current services focused on managing disabilities rather than helping patients achieve a meaningful life in their communities. It also stated that mental health service providers ignored the preferences of consumers and their families.

The articles in Transforming Mental Health Services: Implementing the Federal Agenda for Change, originally published between 2006 and 2009 in Psychiatric Services (journal of the American Psychiatric Association), offer recommendations to assist adults with serious mental illness and children with serious emotional disturbances. They include a series of reforms in which the emphasis is on recovery as an achievable goal, and the need for a person-centered orientation in service delivery. There is also discussion of the reasons many service providers resist using a recovery orientation and how this can be remedied.

Transforming Mental Health Services: Implementing the Federal Agenda for Change consists of updates of papers written by the Commission's subcommittees addressing issues fundamental to those living with mental illness. It is organized into four sections:

  • The first focuses on the interface between mental health and general health, and on employment, housing, and Medicaid financing.
  • The second continues addressing financing and Medicaid as well as issues related to school mental health, recovery, transformation of data systems, and acceleration of research.
  • The third includes reports from four states with transformation initiatives designed to ensure that consumers have a strong voice in the development of recovery-oriented services.
  • The final section describes progress five years after the President's Commission Report and concludes with a proposal by the current director of the Center for Mental Health Services for a public health model of mental health care for the 21st century.

This compilation of well-researched and well-written articles offers an excellent resource for frontline care providers, facility administrators and advocates. It serves as an equally valuable resource for state policy makers who wish to present a convincing case that change is happening and that the recommendations can be translated into effective policies. Although consumers and their families will receive support for their perception that service providers ignore their needs, they will also be encouraged that change for the better is coming to the U.S. mental health care system.


  • Introduction
  • Part I: Updated Issue Papers from the Commission Subcommittees
  • Chapter 1. Transforming mental health care at the interface with general medicine: report for the President's Commission
  • Chapter 2. Employment barriers for persons with psychiatric disabilities: update of a report for the President's Commission
  • Chapter 3. Housing for people with mental illness: update of a report to the President's New Freedom Commission
  • Chapter 4. Issues in Medicaid policy and system transformation: recommendations from the President's Commission
  • Part II: Themes from the Commission
  • Chapter 5. Insights and opportunities: Medicaid directors identify mental health issues
  • Chapter 6. Transformation of children's mental health services: the role of school mental health
  • Chapter 7. The top ten concerns about recovery encountered in mental health system transformation
  • Chapter 8. Barriers to recovery and recommendations for change: the Pennsylvania Consensus Conference on psychiatry's role
  • Chapter 9. Transforming mental health and substance abuse data systems in the United States
  • Chapter 10. Delivery of excellent mental health care and acceleration of research: federal activities since the President's Commission report
  • Part III: State Examples of Transformation
  • Chapter 11. Transformation of the California mental health system: stakeholder-driven planning as a transformational activity
  • Chapter 12. We never used to do things this way: behavioral health care reform in New Mexico
  • Chapter 13. Mental health transformation: moving toward a public health, early-intervention approach in Texas
  • Chapter 14. Developing statewide consumer networks
  • Chapter 15. Mending Missouri's safety net: transforming systems of care by integrating primary and behavioral health care
  • Part IV: Progress and Next Steps
  • Chapter 16. Mental health policy and services five years after the President's Commission report: an interview with Michael F. Hogan
  • Chapter 17. A public health model of mental health for the 21st century

About the Authors

Howard H. Goldman, M.D., Ph.D., is editor of Psychiatric Services.

Jeffrey A. Buck, Ph.D., is Chief of the Survey, Analysis, and Financing Branch, Center for Mental Health Services, Substance Abuse and Mental Health Services Administration.

Kenneth S. Thompson, M.D., is Associate Director of Medical Affairs at the Center for Mental Health Services, Substance Abuse and Mental Health Services Administration.

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